Contraindications to Organ Donation?
Is Candida in the urine culture of a potential organ donor an absolute contraindication to donation?

In order to answer this question, it is important to clarify that most cases of a positive urine culture with Candida are secondary to colonization and not secondary to sepsis or urinary tract infection. In fact, potential donors usually have a urinary catheter in their bladder, and those who spend a long time in the ICU often get colonized with yeast or bacteria.

On the other hand, invasive Candida infection may be transmitted through infected urine from the donor to the recipient of the kidney transplant. There have been reported cases of mycotic aneurysm and perinephric infection that required a nephrectomy of the allograft. In some cases, the infection was caused by contamination of the organ during procurement or from infected preservation fluid.

Therefore, it is important to verify the origin of the positive culture. A urine culture that is positive for Candida is not an absolute contraindication to transplantation, and should be assessed on a case-by-case basis, keeping in mind that serious Candida infection of the kidney may occur.